EMDR Therapy in Los Angeles: How It Works, What It Treats & EMDR vs EFT for Couples
Eye Movement Desensitization and Reprocessing, better known as EMDR, started as an individual trauma treatment and has become increasingly common in couples work, particularly when past trauma is actively shaping how a couple communicates in the present. If you're researching EMDR therapy in Los Angeles, you likely have specific questions about how it actually works, what it can treat, and how it compares to Emotionally Focused Therapy, the other major approach used in couples work.
This guide answers all three.
How EMDR Therapy Works
EMDR is built on the idea that traumatic or distressing memories can get "stuck" in the nervous system in a way that keeps triggering intense emotional reactions long after the original event. Rather than talking through a memory in detail the way traditional talk therapy does, EMDR uses a structured protocol involving guided eye movements, or another form of bilateral stimulation such as tapping or sound, while the person briefly focuses on the memory.
The Eight Phases
EMDR follows a defined eight-phase protocol developed by psychologist Francine Shapiro in the late 1980s:
History-taking and treatment planning
Preparation, including grounding and coping skills
Assessment of the target memory and associated beliefs
Desensitization, the core processing phase using bilateral stimulation
Installation of a more adaptive belief
Body scan to check for residual physical tension
Closure to ensure the person leaves each session feeling stable
Re-evaluation at the start of the next session
A typical course of EMDR involves multiple sessions working through phases 3 through 6 for each target memory, with phases 1, 2, 7, and 8 happening throughout the process.
Why Bilateral Stimulation Matters
The exact mechanism is still studied, but the leading theory is that bilateral stimulation mimics some of the neurological processes that occur during REM sleep, when the brain naturally processes and files away emotional experiences. For people whose trauma memories never got fully processed this way, EMDR appears to help the brain complete that filing process, reducing the emotional charge the memory carries.
What EMDR Treats
EMDR is most recognized for treating post-traumatic stress disorder, and it is listed as an effective treatment for PTSD by organizations including the World Health Organization and the American Psychological Association. Beyond PTSD specifically, EMDR is commonly used for:
Single-incident trauma, such as an accident or assault
Complex or childhood trauma, including attachment injuries from early relationships
Betrayal trauma following infidelity, when the discovery itself functions like a traumatic event
Anxiety and panic that trace back to a specific triggering experience
Grief that has become complicated or stuck
EMDR in a Couples Context
When one or both partners carry unresolved trauma, whether from the relationship itself (such as a betrayal) or from earlier in life, that trauma often shows up in the relationship as disproportionate reactions, difficulty trusting, or a nervous system that stays on high alert around certain topics. EMDR can be used individually alongside couples therapy, or integrated into the couples work itself, to address the trauma directly rather than only working around it in communication exercises.
EMDR vs. EFT for Couples: What's the Difference
Emotionally Focused Therapy, or EFT, is the most widely used couples-specific therapy model, and many couples researching treatment options end up comparing it directly to EMDR. They are not competing options so much as tools aimed at different layers of the problem.
What EFT Does
EFT focuses on the attachment bond between partners. It works by identifying the negative cycle a couple falls into, helping each partner recognize the vulnerable emotion (fear of abandonment, fear of not being enough) underneath their defensive reactions, and creating new, safer ways to express those needs to each other. EFT is almost always done with both partners in the room together.
What EMDR Does
EMDR targets specific traumatic memories, often in an individual, not a joint, session format. It is less about the couple's interactional pattern and more about processing the emotional charge of a particular past experience that is influencing present-day reactions.
When Each Is Used
A couple working through chronic communication breakdowns with no single traumatic trigger usually benefits most from EFT. A couple where one partner's reactions clearly trace back to a specific traumatic experience, a past betrayal, a frightening incident, or an early-life attachment wound, often benefits from adding EMDR, either run concurrently with EFT or in individual sessions alongside the couples work.
Can They Be Combined
Yes, and this is increasingly common. A therapist trained in both approaches might use EFT to work on the couple's relational pattern in joint sessions, while using EMDR in parallel individual sessions to address a specific trauma that keeps getting triggered within that pattern. The two approaches address different layers of the same problem and often work well together rather than as either-or options.
What to Expect From an EMDR Session
A typical EMDR session runs 50 to 90 minutes. Early sessions focus on history-taking, building coping skills, and identifying which memories to target first. Processing sessions, the ones using bilateral stimulation directly, can feel emotionally intense but are structured so the person is guided back to a stable state before the session ends.
Most people need multiple sessions to fully process a single significant memory, and a complex trauma history may require months of ongoing work. Progress is not always linear. Some people notice a shift after just a few sessions, while others need a longer course of treatment.
Frequently Asked Questions
What does EMDR stand for?
EMDR stands for Eye Movement Desensitization and Reprocessing. It is a structured, evidence-based therapy originally developed to treat trauma and PTSD.
How many EMDR sessions does it usually take?
It varies by person and the complexity of the trauma. A single, clearly defined traumatic memory might process in a handful of sessions, while complex or childhood trauma often requires a longer course, sometimes several months of regular sessions.
Is EMDR painful or distressing?
Processing sessions can bring up real emotion, since the person is briefly focusing on a distressing memory. However, EMDR is structured to keep the person grounded throughout, and sessions always end with a closure phase to ensure stability before leaving.
Can EMDR be used for couples, or only individuals?
EMDR is primarily an individual therapy technique, but it is frequently used alongside couples therapy, either in parallel individual sessions for one or both partners, or integrated by a therapist trained in both approaches.
What's the difference between EMDR and EFT?
EFT works directly with both partners together to change the relational pattern and attachment bond between them. EMDR works with an individual to process a specific traumatic memory. Many couples benefit from both, used together.
Does EMDR really work, or is the evidence limited?
EMDR has a substantial evidence base for PTSD treatment and is recognized by the World Health Organization and the American Psychological Association as an effective trauma treatment. Research on EMDR for couples-specific applications is newer but growing.
Can EMDR help after infidelity?
Yes. Betrayal trauma, the intense and often trauma-like reaction to discovering infidelity, responds well to EMDR in many cases, since the discovery itself can function like a traumatic event that keeps replaying.
How do I know if I need EMDR, EFT, or both?
A consultation with a therapist trained in both can help clarify this. Generally, if a specific past event keeps derailing the relationship, EMDR is worth considering. If the issue is more about a repeating communication pattern without one clear traumatic trigger, EFT alone may be the better starting point.
Getting Started
If past trauma, whether from the relationship or earlier in life, feels like it's shaping how you and your partner communicate today, it's worth talking to a therapist trained in both EMDR and couples-specific approaches like EFT. At Couples Healing Center, our clinicians work with individuals and couples across Los Angeles, Long Beach, and Orange County, in person and virtually.
If you'd like to talk through what approach would fit your situation, you can schedule a complimentary consultation with our team.
Written by Dr. Liz Wee, licensed relationship & sex therapist and founder of Couples Healing Center.
